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Objective To understand the exposure level of disinfection by-products (DBPs) in drinking water in Xiangyang City and to evaluate the health risks of the population, so as to provide reference for the safety risk control of drinking water. Methods Sampling and laboratory testing were conducted according to national standard methods. The risk assessment model provided by USEPA was used to evaluate the health risks. Results Trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM) and tribromomethane (TBM) were detected in drinking water in Xiangyang City. The contents of halogenated hydrocarbon DBPs in water disinfected with liquid chlorine were higher than those with chlorine dioxide. The contents of three DBPs were higher in wet season than those in dry season except TBM. The content of TCM in pipe network terminal water and secondary water supply disinfected with chlorine dioxide was higher than that in factory water. The carcinogenic risk of DBPs in drinking water disinfected with liquid chlorine was 4.33×10-5, and the non-carcinogenic risk was 0.114. The carcinogenic risk of DBPs in drinking water disinfected with chlorine dioxide was 1.24×10-6, and the non-carcinogenic risk was 3.15×10-3. Conclusion The health risk of DBPs in drinking water in Xiangyang City is acceptable, but TCM produced by liquid chlorine disinfection should be paid more attention. It is recommended that chlorine dioxide disinfection be used to reduce the health risks of halogenated hydrocarbon DBPs.
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Objective:To investigate the effect of O-6-methylguananine-DNA methyltransferase (MGMT) gene promoter methylation status on the treatment and prognosis of elderly patients newly-diagnosed with glioblastoma (GBM).Methods:Clinical data of 65 newly-diagnosed GBM patients admitted to Tianjin Huanhu Hospital from January 2012 to December 2018 were retrospectively analyzed. All patients received intensity-modulated radiotherapy after surgery and 49 patients received temozolomide (TMZ) monotherapy. All patients were divided into the MGMT(+ ) group and MGMT(-) group according to the methylation status of MGMT promoter. Kaplan- Meier method and log-rank test were used for univariate survival analysis, and Cox regression model was used for multivariate prognostic analysis. Results:The median overall survival (OS) for all patients was 18.0 months. The median OS was 27.0 months and 15.3 months in the MGMT(+ ) group and MGMT(-) group, respectively. Univariate analysis revealed that tumor number, MGMT promoter methylation, postoperative concurrent chemoradiotherapy were significantly related to clinical prognosis ( P=0.029, P=0.001 and P<0.001). In multivariate analysis, tumor number and postoperative concurrent chemoradiotherapy were identified as significant prognostic factors for OS ( P=0.037, P=0.004). In the MGMT(+ ) group, the median OS was 27.0 months for patients receiving concurrent chemoradiotherapy and 12.0 months for radiotherapy alone ( P=0.040). In the MGMT(-) group, the median OS was 17.0 months for concurrent chemoradiotherapy patients and 10.0 months for radiotherapy alone ( P=0.122). Conclusions:MGMT promoter methylation status is significantly associated with longer OS in elderly GBM patients. Conventional fractional radiotherapy combined with concurrent and sequential TMZ chemotherapy probably yields better survival benefits.
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Objective Investigate the relationship between gross tumor volume (GTV)-related factors including GTV-T volume,the maximum thickness of the esophageal lesion plane and GTV-T volume/length(GTV-T volume divided by the length of the lesion calculated by the number of GTV-T layers) and the locoregional failure of radical intensity-modulated radiation therapy (IMRT) for esophageal carcinoma.Methods A total of 133 patients with esophageal cancer undergoing radical IMRT were enrolled.The factors related to GTV-T including GTV-T volume,the maximum thickness of the esophageal lesions,GTV-T volume/length were calculated.The relationship between GTV-T related factors and local recurrence of tumors was retrospectively analyzed.Results There was positively linear association between the locoregional failure rate of GTV-T and the volume of GTV-T.The volume of GTV-T tumor was 36 cm3,the maximum wall thickness was 2.5 cm,and the GTV-T volume/length was calculated as 5.3 cm2.These critical values could be utilized to predict the risk of locoregional failure of IMRT for esophageal carcinoma.Conclusions The GTV-T factors can be adopted to predict the local control and the risk of locoregional failure of radical IMRT for esophageal carcinoma to certain extent.
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Objective To analyze the effects of gross tumor volume(GTV-T)and positive lymph node volume(GTV-LN)on the prognosis of radical concurrent chemoradiotherapy for esophageal squamous cell carcinoma(ESCC). Methods A total of 79 patients with stage N1ESCC undergoing radical radiotherapy in our hospital from 2012 to 2015 were enrolled as subjects. GTV-T and GTV-LN were calculated by the Pinnacle39.0 treatment planning system. The receiver operating characteristic(ROC)curves were used to evaluate the value of the GTV-LN/GTV-T ratio in the prediction of local recurrence(LR)and distant metastasis(DM)of ESCC. Results The median follow-up time was 17.2 months in all patients. The ROC curves were made using the GTV-LN/GTV-T ratio. The optimal cut-off values of GTV-LN/GTV-T ratio for predicting the risk of LR and DM were 0.34 and 0.59, respectively. The statistical analysis revealed that the LR rates were 50% and 8% in patients with GTV-LN/GTV-T ratios of<0.34 and ≥0.34, respectively(P<0.01), while the DM rates were 11% and 43% in patients with GTV-LN/GTV-T ratios of<0.59 and ≥0.59, respectively(P= 0.003). Conclusions The GTV-LN/GTV-T ratio may be a predictor of LR and DM in patients with ESCC. Further studies on the GTV-LN/GTV-T ratio may help to make personalized chemoradiotherapy strategies for patients with ESCC.
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Objective To evaluate the incidence of and risk factors for esophageal fistula and fatal bleeding after intensity?modulated radiotherapy ( IMRT) for esophageal cancer. Methods Clinical data were collected from 128 patients with esophageal cancer who received radical IMRT in our hospital from January 2012 to December 2014. According to the incidence of esophageal fistula and fatal bleeding, those patients were divided into control group ( n= 105 ) and severe complications group ( n= 23 ) . In the severe complications group,12 patients had esophageal fistula and 11 fatal bleeding. Between?group comparison was made by χ2 test. The Cox model was used for the multivariate analysis. Results Chest and back pain in the initial diagnosis,clinical stage cT4 ,tumor type ( ulcerative) ,gross tumor volume ( GTV)>50 cm3 ,and GTV maximum diameter>2?45 cm were risk factors for esophageal fistula and fatal bleeding after radiotherapy for esophageal cancer (P=0?042,0?042,0?019,0?046,0?002).The multivariate analysis showed that tumor type ( ulcerative) and GTV maximum diameter were independent risk factors for esophageal fistula and fatal bleeding ( P=0?010,HR=0?329,95% CI:0?142?0?763;P=0?009,HR=3?805,95% CI:1?404?10?312) . Conclusions The efficacy of IMRT is severely restricted by the incidence of esophageal fistula and fatal bleeding. For patients with an ulcerative type of esophageal cancer or a GTV max diameter of>2?45 cm,the chemoradiotherapy plan should be optimized to reduce the risk of severe complications.
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Objective To investigate the value of lung adenocarcinoma classification developed by International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society ( IASLC/ATS/ERS) in predicting the effect of three-dimensional radiotherapy ( 3DRT) after surgery for locally advanced lung adenocarcinoma.Methods The clinical data of 150 patients with invasive lung adenocarcinoma who underwent radical resection and systematic lymph node dissection in Tianjin Medical University from 2010 to 2013 were analyzed, and according to the IASLC/ATS/ERS classification, they were divided into lepidic predominant group (LEP group), acinar predominant group (ACN group), papillary predominant group (PAP group), micropapillary predominant group (MIP group), and solid predominant group (SOL group), and further divided into LEP group, CAN/PAP group, and MIP/SOL group.The overall survival ( OS) and disease-free survival ( DFS) rates were compared between groups.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for survival difference analysis and univariate prognostic analysis, and the Cox proportional hazards model was used for multivariate prognostic analysis.Results Among all the patients, the median OS and DFS rates were 30.8 and 25.8 months, respectively.For the patients in the LEP group, ACN/PAP group, and MIP/SOL group, the median OS rates were 40.0, 32.2, and 28.4 months, respectively ( P=0.005) , and the median DFS rates were 29.2, 25.8, and 24.2 months, respectively ( P=0.011) .For the ACN/PAP group, the patients who received or did not receive radiotherapy had a median OS rate of 37.4 or 25.3 months ( P=0.000) and a DFS rate of 31.1 or 25.2 months (P=0.000).For the MIP/SOL group, the patients who received or did not receive radiotherapy had a median OS rate of 28.3 or 27.4 months ( P=0.783) and a DFS rate of 25.3 or 24.0 months ( P=0.732 ) .Conclusions The IASLC/ATS/ERS classification helps to predict the prognosis of patients with locally advanced invasive lung adenocarcinoma who receive postoperative radiotherapy.Postoperative radiotherapy can be performed for ACN and PAP patients, while there is no need to perform radiotherapy for MIP and SOL patients .
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Objective To investigate the prognostic significance of postoperative radiotherapy (PORT) for locally advanced pulmonary adenocarcinoma with micropapillary pattern(MPPAC).Methods A total of 45 completely resected pN2-3 cases that occured from January 2012 to December 2014 at Tianjin Medical University Cancer Hospital were retrospectively analyzed.All of them were diagnosed with MPPAC by pathological diagnosis.Based on whether receiving PORT, patients were divided into radiotherapy and non-radiotherapy groups.General characteristics, overall survival and disease-free survival characteristics of the two groups were compared, respectively.Results The median overall survival (OS) of patients was 19.8 months, 1-year and 2-year overall survival rate was 79.4％ and 30.3％ , respectively.The median disease free survival (DFS) of patients was 13 months, 1-year and 2-year, and the disease free survival rate was 59.3％ and 28.9％ , respectively.The radiotherapy and non-radiotherapy groups exhibited median OS of 22.3 and 11.4 months,respectively (x2=13.329, P＜ 0.05) , and corresponding D FS of 16.2 and 10.4 months(x2 =7.972 ,P ＜0.05).The epidermal growth factor receptor gene (EGFR) mutation rate of patients was 57.14％ (20/35), In the subgroup analysis, for patients with EGFR mutation, the radiotherapy and non-radiotherapy groups showed median OS of 25.6 and 18.4 months, respectively(x2 =9.268,P ＜ 0.05) , and corresponding DFS of 21.6 and 12.6 months (P ＞ 0.05).For patients with wildtype EGFR, the radiotherapy and non-radiotherapy groups showed median OS of 21.8 and 10.6 months,respectively(x2 =9.595,P ＜ 0.05) , and corresponding DFS of 15.2 and 6.6 months(x2 =4.538,P ＜0.05).Conclusions PORT could improve survival of patients with pN2.3 MPPAC.For patients with locally advanced MPPAC after curative resection, PORT is still an integral part of treatment.
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Background Previous retinal vascular mounting only obtained part of retinal vessels for the study of retinal diseases,and thus it is difficult to comprehensively assess these diseases.So optimizing the trypsin digestion method to show the complete retinal capillary network is very important for the study of retinal diseases.Objective This study was to modify the preparing way of trypsin digested whole retinal capillary network and offer a basis for a quantitative analysis of cells and capillaries.Methods Thirty Wistar rats were divided into model group (20 rats) and control group (10 rats).Streptozotocinum(STZ) of 1.25％ dissolved in 0.05 mmol/L sodium citratehydrochloric acid buffer was intraperitoneally injected to establish diabetes models in the model group,and the equal volume of solvent was used in the same way in the control group.Eight months after injection,100 ml PBS was injected via ventriculus sinister and released via cut right atrium,and then 100 ml 4％ paraformaldehyde was injected into the ventriculus sinister.The rat retinas containing part of the optic nerve were entirely isolated,and digested by trypsin,and vitreous,inner limiting membrane and neural retinal tissue were removed.The whole retinal capillaries network was mounted on the slide.The ghost pericytes and acellular capillaries in the middle retinal area were identified and counted under the optical microscope.Results The retinal mount exhibited that the retinal vessels were stained by hematoxylin and periodic acid schiff.The vessels network presented with the entire type in shape with the radical central retinal arteries and veins and their branches.The capillary showed the shallow-and deep-layer networks between the small arteries and veins.Pericytes distributed and protruded vessel wall and formed the ghost cells without nuclei.The diameter of acellular capillaries was 20％ or more than that of near capillaries,and no cellular nuclei or ghost cell was found through the vessel.Conclusions The experimental technique for setting-up of cleaned vasculature and mounting vessels on glass microscopic slide provides intact vessels,which is helpful for the evaluation of retinal vascular morphology and quantitative analysis.
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0 05). For enalapril treatment, the total efficacy rate in patients in Tibet and coastal areas was 96 0% and 77 6%( P 0 05).